Plantar fasciitis

Plantar fasciitis causes pain normally under the heel when the plantar fascia becomes inflamed. The plantar fascia is a strong band of tissue, similar to a ligament. It stretches from the heel to the middle of the foot. It supports the arch of your foot and small injuries to it can cause inflammation and symptoms most likely near your heel.

Who gets it?

It is a fairly common problem mainly in people over 40, and is more common in women. You are more likely to get it:

• if you do lots of walking, running, standing, when you are not use to it
• wearing shoes with poor cushioning
• sudden gains in weight or being overweight will put increased strain on the heel
• overuse or sudden stretching of the sole
• tightness of the achilles tendon (bottom of calf muscle)

Normally the inflammation and pain will ease in time as the fascia heals slowly. It may take several month or more to go. To try and help speed the recovery the following should help rest the foot as much as possible. Gentle exercise and stretches as described later in the leaflet are fine.

• footwear - avoid walking barefoot on hard surfaces and choose shoes that have a cushioned heel with good arch support. Avoid old or worn shoes.
• painkillers - your GP can advise on this but often paracetamol or anti-inflammatory medication is
  recommended.
• steroid injections are sometimes tried if other measures do not work. Your GP can advise you on these.

Surgery may be considered in very difficult cases and is not always successful and is often considered a last resort.

Gentle walking, swimming or cycling is fine, together with the stretches below. Regular stretching of the achilles tendon and the plantar fascia will help ease your symptom. Tightness in these structures is often the cause of your pain. Try the stretches on the next page.

The aim of these stretching exercises is to loosen the fascia and tendons. They must not make you worse. If they do reduce the number of times you repeat them, or stop for a day or two.

Stand in a walking position with the leg to be stretched straight behind you and the other leg bent in front of you. Take support from a wall or chair.
Lean your body forwards and down until you feel the stretching in the calf of the straight leg. Hold for about 30 seconds - relax.
Repeat 5-10 times, 3-4 times a day.

Stand with your back against a wall and your knees slightly bent. Or, sit in a chair with your knees at right
angles, feet flat on the floor.
Lift your toes and front of foot off the floor. Keep your heels on the floor.
Hold for 30 seconds.
Repeat 5-10 times, 3-4 times a day.